Businesses Need Reasons To Stay in Coverage Game

Businesses Need Reasons To Stay in Coverage Game

Employers stand by the exit signs in the back as echoes ring through the great hall of public discourse about the Patient Protection and Affordable Care Act. Everybody wants to know: What will be the effects of implementation? Meanwhile, the businesses that sponsor most of the coverage in the country jiggle their keys and check their watches. They’ve got a pretty good idea.

As we were putting this issue to bed, a survey was saying that 91 percent of doctors “reported believing that physicians order more tests and procedures than needed to protect themselves from malpractice suits.” According to the survey, in the Archives of Internal Medicine, an overwhelming number of generalists (91 percent), specialists (89 percent), and surgeons (93 percent) hold that view. Tests and procedures are ordered whether they’re needed or not. As much as $60 billion might be lost due to defensive medicine, the study says.

Paul Fronstin, PhD, a senior researcher and director of the health research and education program at the Employee Benefit Research Institute, says that these days the employer asks the health plan: What innovative ways can you come up with to keep my costs under control?

Insurers address this in many ways. Yet, as the study about defensive medicine indicates, they do not now, nor ever will, control every aspect of medical coverage. That’s another thing employers know.

Managed Care's Prospects in the Health Reform Era

Princeton’s Uwe Reinhardt, PhD, renowned health care economist, sits down with Managing Editor Frank Diamond to discuss the economic effects of the Affordable Care Act, wellness programs, and the state of health care in the United States in general.